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What are warts?
Foot warts (sometimes called verrucae) are small growths that develop in the skin. Warts are associated with human papillomavirus and are contagious. Warts can often be very painful and can limit your activities if left untreated.
When you are walking barefoot, the virus enters your body through breaks in the skin on the bottoms of your feet. You can easily develop warts on your toes, making it painful for you to walk.
When warts form in clusters, it is called a “mosaic” wart. Oftentimes, warts may just go away on their own. However, if they are persistent they should certainly be treated. Although warts can be painful, most are harmless. Occasionally, a lesion can be mistaken for a wart but maybe something more serious such as skin cancer.
How you may have developed warts on your toes…
Everyone’s immune response is different. As I stated before, most people will pick up warts while walking barefoot in public environments. These places include swimming pool floors, locker rooms, gyms, and communal showers. However, not everyone who comes into contact with a wart will develop them.
It is not uncommon for one person in the family to suffer from warts, while others in the family don’t. Also, it’s not unusual for warts to appear weeks or months after initial exposure to the virus.
Who is at higher risk for developing a wart?
- Children, adolescents, and teenagers
- Immunocompromised patients such as patients who are receiving chemotherapy or have HIV
- Athletes (more exposure to locker rooms)
What are the symptoms to look out for?
You may notice a callus buildup in the area of the wart. You’ll also want to look for black dots in the center of the wart. These black dots are blood vessels in the wart, so don’t pick at them! You don’t want the wart to spread to your fingers.
Also, you may notice that you have a hard time visualizing your footprint through the wart site, whereas when you have a callus, they are easily visible. If you have warts on your toes, then they may look white or even flesh-colored.
However, they are often raised and can be very painful. The skin between the toes is very sensitive, and warts on the toes are often difficult to treat.
How are warts diagnosed?
It’s best to seek treatment by your physician to accurately diagnose your warts. Oftentimes, a simple biopsy is taken of the lesion and sent to the lab to confirm a wart, and more importantly, rule out cancer.
Skin cancers such as squamous cell carcinoma, and melanoma, can look like warts and should be taken very seriously. The only way to be sure that your wart is not skin cancer is through an appropriate and timely biopsy.
How you can treat a plantar wart?
Did you know there are over 500 ways to treat warts in the literature? These pesky viruses are very resistant to treatment, thus making them difficult to treat.
There are so many remedies, soaks, and oils that come highly recommended on the internet. However, in my experience, it is better to see a doctor to help treat the virus. There is just not enough evidence to prove that herbal and home remedies alone are effective.
Various treatments exist for plantar warts including:
Over-the-counter acids such as Salicylic acid
Essentially, these acids cause the tissue overlying the wart to slough off slowly. If you use Salicylic acid for warts on your toes, proceed with caution!
Applying too much of the acid on your toes can cause the skin to become too wet or even blister. Also, for acid application to be effective, the tissue overlying the wart should be trimmed off. This will allow the acid to penetrate better.
Trimming of the wart should only be done by your doctor. If you try to do it yourself, you may cut yourself and put yourself at risk for infection.
Pro tip: Non prescription Salicylic acid is usually weaker in strength than prescription strength Salicylic acid that your doctor would put on your foot. So if you find no luck with application of the over the counter acid, it’s time to call your doctor.
Cryotherapy
Your doctor will apply liquid nitrogen to the wart. This will cause the wart to blister, and thus fall off. You may need to receive a few treatments before the wart resolves.
Electrocautery of the wart
Your doctor will first anesthetize the wart using a local anesthetic, and then use a machine called a “hyfrecator” to burn the wart. This can be painful for several days after the procedure, but it is very effective. However, burning a wart on a toe can be slightly more painful, due to skin sensitivity. Also, it’s common to see mild scarring from the procedure.
Prescription Acids
Your doctor may choose to use other acids on your wart, such as Trichloroacetic acid, Monochloroacetic acid, and Cantharidin, all of which aggressively chemically treat the wart.
You may have to come in every 3-4 weeks for treatment until the wart is resolved.
Laser therapy
Some doctors will suggest laser therapy. The pulse-dyed laser essentially burns the wart in a targeted manner. You will need to go in regularly for treatment.
Excision
Finally, warts can also be excised completely. This should only be performed by your doctor. This is usually a last resort because to close the skin after a wart is removed, your surgeon will need to make a larger incision. So for your wart to be cut out, the wart must be small. Patients should be warned about potential scar tissue formation. Sometimes, scar tissue can cause more pain than the wart itself.
Tips on how to manage warts…
- Keep your warts covered with adhesive tape
Whether it’s duct tape or any adhesive tape, it’s important to keep your wart covered between treatments. Each time you peel away the adhesive tape, the outer layer of the wart may be removed more easily. You can also soak your wart in warm water, and remove the outer dead tissue of the wart using a pumice stone.
- Change your shoes and socks daily
Again, it’s important not to spread the wart. Make sure to change your socks daily. Better yet, if you share a house with others, you can try wearing house slippers to prevent spreading the wart.
- Be careful to keep your feet protected while walking in public places (gyms, locker rooms)
- Keep your feet clean and dry!
The biggest reason warts are so quick to spread when on the toes is because warts love to thrive in wet and moist environments.
It’s common to see them multiply quickly because it’s so easy for sweat to accumulate between the toes.
- Don’t share razors, towels, or other personal items that contact the skin with others.
- Manage painful warts by using doughnut-shaped pads around warts. This will provide you some relief while walking.
- If you have warts on your toes, you can try applying a metatarsal pad on your shoe liner to help offload pressure from your toes a bit when you walk.
- Avoid shoes that may cause you to put more pressure on your warts. For instance, high heels can be uncomfortable to wear when you have warts on your toes or your heels!
- You can take over-the-counter pain medication such as Motrin or Tylenol as recommended by your doctor to manage pain.
When to call your doctor
The reality is that a lot of people will try to treat their warts themselves first before seeking help at a physician’s office. If you notice any of these symptoms below, please call your doctor as soon as possible:
Redness, warmth, and pain at the wart site
This suggests a skin infection is present and must be treated accordingly with antibiotics.
The warts are spreading
As I mentioned before, when you have warts, especially warts on your toes, they can spread rapidly. The bigger your warts are, the harder they become to treat. It’s better to seek a professional opinion sooner than later.
When you are unsure if you have a wart or skin cancer
If you notice that the wart is not flesh-colored, and instead resembles a black, blue, or brown color, it’s best to see a doctor for a quick biopsy to rule out skin cancer.
Conclusion
In conclusion, warts can affect people of any age and should be taken seriously. If left untreated, they can easily replicate and cause significant pain. When warts starts to interfere with your daily life, it’s time to seek help from your doctor!
Do you suffer from warts? Is there anything else you would like to know about this topic? Leave a comment below!
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Photo credits:
- Simon Nuttall assumed (based on copyright claims)., CC BY-SA 3.0 http://creativecommons.org/licenses/by-sa/3.0/, via Wikimedia Commons
- Marionette, CC BY-SA 3.0 https://creativecommons.org/licenses/by-sa/3.0, via Wikimedia Commons
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